Joseph C. Maroon, MD, FACS is clinical professor and vice chairman of the Department of Neurological Surgery and Heindl Scholar in Neuroscience at the University of Pittsburgh Medical Center. In addition to being a renowned neurosurgeon, he is a sports medicine expert, health and nutrition expert and Ironman triathlete.

Dr. Maroon, the neurosurgeon

Dr. Maroon is regarded as a premiere specialist in the surgical treatment of injuries and diseases of the brain and spine, specializing in minimally invasive procedures. Consistently listed in America’s Best Doctors for the past 20 years, he has an international referral base, including numerous professional athletes and celebrities.

Dr. Maroon obtained his medical and neurosurgical training at Indiana University, Georgetown University, Oxford University in England and the University of Vermont. He conducted extensive research into neurotrauma, brain tumors and diseases of the spine, which has led to many innovative techniques for diagnosing and treating these disorders. His research efforts garnered him numerous awards from various national and international neurological societies.

Dr. Maroon is the author of six books, and (co-)author of 40 book chapters and over 270 published scientific papers. He has given more than 150 presentations at national and international conferences and is often invited as visiting professor and key-note speaker. He has served on the editorial boards of eight medical and neurological journals and is currently associate editor of Surgical Neurology, and editorial board member of Neurological Research and The Physician and Sports Medicine journals. He also is past-President of the Congress of Neurological Surgeons, the largest society of Neurosurgeons in the world.

Dr. Maroon, the sports medicine expert

Dr. Maroon has been the team neurosurgeon for the Pittsburgh Steelers since 1981, and is Medical Director of the World Wrestling Entertainment (WWE). He has successfully performed surgery on numerous professional football players and other elite athletes with potentially career-ending neck and spine injuries. Notably, he safely returned most to their high level of athletic performance.

Dr. Maroon is highly invested in the prevention and treatment of concussions in high school, college and professional sports, specifically football. While working with the Steelers in the early 1990’s, the lack of an objective, reliable instrument to evaluate concussion symptoms became very apparent to Dr. Maroon. To fill this void, he and Dr. Mark Lovell developed ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing), an easy-to-administer, 20 minute long test to assess presence and severity of concussion symptoms. ImPACT™ has become the world-wide standard tool to assess sports-related concussions, and has been used in over 4.5 million athletes. In 1994, Dr. Maroon joined the National Football League’s mild Traumatic Brain Injury Committee as concussion expert. This committee, which in 2007 was renamed National Football League’s Head, Neck and Spine Committee, is still in place.

For his expertise on sports medicine and concussions, Dr. Maroon is frequently interviewed and quoted by the media, including the New York Times, USA Today, Associated Press, ESPN, Sports Illustrated, and ABC News Nightline.

Dr. Maroon, the health and nutrition expert

Dr. Joseph Maroon has a major interest in regenerative medicine and is senior Vice-President of the American Academy of Anti-Aging Medicine. Furthermore, he is on the Board of Directors of Mylan Laboratories, the 3rd largest Generic drug company in the world and is Chairman of their Science and Technology Committee. Dr. Maroon is also Chairman of the Medical advisory board of General Nutrition Centers (GNC).

Dr. Maroon developed research interests in the use of omega-3 fatty acids as a safe and natural alternative to non-steroidal anti-inflammatory drugs (NSAIDs) in treating neck and low-back pain in patients with disc and arthritic causes. He wrote the book, Fish Oil: The Natural Anti-Inflammatory, which highlights many of the benefits of fish oil, not just for back-pain, but also for general good health.

Through his intensive athletic involvement, Dr. Maroon has a personal interest in healthy living and healthy nutrition. He is much invested in keeping his expertise up to date as he “practices what he preaches”.

Dr. Maroon, the athlete

Dr. Maroon received an athletic scholarship to Indiana University in Bloomington, Indiana where as an undergraduate, he was named a Scholastic All-American in football. Dr. Maroon has successfully maintained his personal athletic interests through participation in 9 marathons and more than 72 Olympic-distance triathlon events. However, his greatest athletic accomplishment is his participation in 8 Ironman triathlons (Hawaii – 1993, 2003, 2008, 2010, 2013; Canada – 1995; New Zealand – 1997; Germany – 2000), where he usually finishes in the top 10 of his age group. Recently, in July 2012 and 2013, he finished second and third, respectively, in his age group in the Muncie, Indiana half Ironman triathlon. In October 2013 he completed his 5th World Championship Ironman in Kona, Hawaii.

As a result of his athletic dedication and performance, Dr. Maroon (along with NFL’s great Joe Montana and NBA legend Kareem Abdul-Jabbar) was inducted into the Lou Holtz Upper Ohio Valley Hall of Fame for his athletic accomplishments and contributions to sports medicine on June 27, 1999. Eleven years later, on March 14, 2010 he was inducted into the National Fitness Hall of Fame in Chicago. Other inductees include Gov. Arnold Schwarzenegger; Jack LaLanne; and Kenneth Cooper, founder of the Aerobic Movement.

For all his accomplishments, Dr. Maroon was in 2011 selected as a “Distinguished Alumnus” of Indiana University—one of 5 selected annually from 500,000 alumni from the university.

To schedule an appointment with Dr. Maroon, please give us a call at 1-888-234-4357

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Hospitalization and Insurance:

If you are hospitalized, our office will arrange for your admission. We admit patients to the hospitals of UPMC Health System, including UPMC Presbyterian and UPMC Passavant. We accept most health insurance plans, including those outside the UPMC Health System. Below you find the most current list of plans we accept, but this information can change. Please call our office at1-888-234-4357 to see if your health plan is included, even if it is not listed below:

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Athletes Concussion and CTE

Introduction

When an athlete, whether it is football, soccer, lacrosse or any sport, suffers a blow to head depending on the force, direction and condition of the athlete a concussion can occur. It can be painful for the athlete as well as frightening to a spectator to watch. We instinctively know we must protect our brain from trauma. Our hands reflexively move to our head to block an incoming blow.

Over the last several years concussion researchers and the medical community have reported definitive evidence that a brain concussion may have both short-term and long-term negative consequences and must be treated properly just like any other injury. Despite this isolated media stories continue report on athletes from pee-wee leagues through the pros who are still ignoring these warning and lying about having suffered a concussion.

Research being done on those that suffered a concussion, both living and deceased, continues to suggest that blows to the head can have consequences to both brain function and structure. Like all other organs and parts of the body the consequences of abuse will eventually be revealed as we age. A knee joint traumatized daily in sport with running, stopping, twisting and being hit will eventually develop stiffness, soreness, swelling and degenerative changes leading to some type of disability. The brain may also suffer in this same way as a result of trauma and just as with the knee the mechanism is most likely in part due to our own body’s inflammatory response. Prevention and proper initial management are essential.

Chronic progressive traumatic encephalopathy or CTE

Since the late 1920’s scientist have recognized head trauma can induce neurodegeneration when examined during an autopsy. First described as “Punch drunk syndrome” in boxers, later called dementia pugilistica (DP), and then more recently chronic progressive traumatic encephalopathy or CTEthis condition has become a major health concern in amateur and professional sports. Currently, there are no definitive tests to distinguish CTE from other neurodegenerative diseases other than by evaluation of brain tissue. For this reason published reports of CTE thus far have been limited to individual and small collections of case studies of mostly former athletes who had a history of dementia or major psychological issues.

CTE has now been reported in a wide range of individual athletes, combat military personnel and others who had suffered some form of traumatic brain injury (TBI) years to decades prior to their deaths. Because concussions and blows to the head are common in both sports and the military there is a concern by many former athletes and veterans that symptoms of dementia and other brain related problems, especially with aging, may have some relationship to prior head trauma.

From an article published in February 2015 in the journal PLOS ONE, (Click Here to see Article) we found 150 autopsy confirmed cases of CTE in the world literature from 1954 to August 2013. (Three additional case were reported in the media) These cases are mostly divided between former boxers and former football players. The only common consistent finding thus far as a risk factor in the CTE case reports has been a history of prior brain trauma.

Brain Degeneration: CTE vs Alzheimer’s Disease

Because of these concerns an enormous amount of research is underway to help determine the risk factors, better ways to detect this condition and possible ways to prevent CTE in those with a history of concussion and head injury. At the current time there have been approximately only 150 autopsy confirmed cases of CTE. These cases are mostly divided between former boxers and former football players. The only common consistent finding thus far for as a risk factor in the CTE case reports has been a history of prior brain trauma.

Because CTE condition has been seen in a relatively small number deceased people and all other research models are being used to understand CTE. Alzheimer’s disease (AD) is considered a comparable model due to similar changes seen in brain degeneration (called neurodegeneration) and the similar neurological decline as often found with CTE. Prior head injury is also a risk factor for the development of AD as well. But unlike CTE additional risk factors have been found with AD. These include: Advancing age, genetic mutations, family history of the disease and underlying heart and vascular disease. Whether these factors also play a role in the development of CTE is unknown at this time.

AD has now been studied for decades and much is known about what happens to brain cells as AD degenerative changes start to occur in the brain. AD in the past was generally believed to progress no matter what treatments or interventions were tried to slow or stop the condition. There are now recent advances both in pharmaceuticals and nutritional treatments along with behavioral and lifestyle changes which have proven very beneficial to slow AD symptoms and brain cell changes. Specifically, large population studies investigating AD report lifestyle, habits, diet, nutritional status, types of medications and dietary supplements allow certain people to be less likely to suffer from AD. One of the reoccurring findings in these studies has indicated that those interventions that can reduce brain inflammation and improve optimal nutritional supplies to the brain put people at less risk for developing AD.

Lifestyle Factors Often Associated with Alzheimer’s disease:

Lack of exercise

Smoking

High blood pressure

High blood cholesterol

Poorly controlled diabetes

A diet lacking in fruits and vegetables

Lack of social engagement

Common Symptoms Reported/Seen in those with Alzheimer’s disease and CTE

Memory problems

Getting lost – Not recognizing surroundings

Speech and Writing changes

Difficulty with Reasoning Skills, Decision making and Judgment

Personality changes

Depression

Social withdrawal

Mood swings

Distrust in others

Irritability and aggressiveness

Changes in sleeping habits

Wandering

Loss of inhibitions

Delusions, such as believing something has been stolen

Inflammation and Brain Cell Health

What happens during mild brain trauma and concussion in the short-term is well known, but the long term consequences such as post-concussion and CTE under intensive investigation. There is, however, a general agreement that brain cells are very sensitive to the environmental status of the brain. If blood oxygen levels are low we lose consciousness in one to two minutes and cell death can occur in seven. No other cells in the body are this fragile. This sensitivity is also true with low blood glucose levels, deficient levels of micronutrients, excessive stress hormones like cortisol and inflammatory factors such as free radicals.

Treatments to reduce inflammation to maintain brain health can be effective since inflammation in the brain has been linked to cognitive decline, neurodegeneration and metabolic abnormalities. The aging brain is also more prone to neuroinflammation. Inflammation throughout the body due to high dietary fats, smoking or other environmental toxins, stress, obesity or lack of exercise can contribute to poor brain health and premature brain aging.

Because there is no definitive medical treatment for CTE at this time using AD as a treatment model of degenerative and inflammatory brain changes may help direct interventions that benefit those at risk for CTE.

Below are several healthy interventions known to both strengthen and weaken brain cells and inflammation in both the body and brain.

Dietary Interventions to Inflammation

Dietary components such as diets rich in saturated fats, transfats (hydrogenated or partially hydrogenated oils), and processed foods with lots of simple sugars can stimulate inflammation. Diets such as the Mediterranean diet rich in olive oil, fruits and vegetables, nuts, beans, and whole grains has been shown to reduce inflammation. Consuming alcohol only in moderation has been associated with less inflammation compared to excessive alcohol intake can increase inflammation. In general one to two glasses of red wine per day can also provide the benefit of concentrated polyphenols, which are known to have antioxidant properties, have been found to provide a health benefit.

The essential fatty acids omega-3 found in oily fish and fish oil supplements contain molecules known to decrease several markers of inflammation, whereas increasing dietary intake of omega-6 fatty acids found in corn oils and most processed foods can increases inflammatory markers. Other supplements such as vitamins, minerals, and herbs can reduce inflammation levels. Spices turmeric (curcumin), ginger and Boswellia serrate can inhibit inflammatory pathways. Catechins, found in teas, have antioxidant and anti-inflammatory effects. Alpha-lipoic acid, as a dietary supplement, has anti-inflammatory properties.

Lifestyle Interventions to Inflammation

Maintaining a healthy body weight has been shown to control chronic inflammatory diseases and also weight loss has been shown to decrease chronic disease such as diabetes and even cognitive decline and AD. Smoking cessation and reduced exposure to environmental pollution has been reported to decrease all biomarkers of inflammation. Stress results in the release of a hormone called cortisol the can actually kill brain cells if the stress remains chronic. Stress reduction can not only help to preserve brain cells it can lower blood pressure and risk for heart disease and stroke.

Regular physical exercise is good for us, no matter what our age. This is especially true as we age. Exercise supports a healthy heart and blood pressure, healthy immune system and improved blood sugar levels. Recent research shows that regular physical exercise can also improve brain function and reduce memory problems associated with aging. Physical exercise has a major strengthening impact on the structure of the brain. Both animal and human cell studies have shown that exercise causes new nerve cells to grow, called neurogenesis, disproving a once held belief that humans can’t grow new brain cells. Exercise can cause the release of BDNF, a hormone, which has the capacity to increase the number of brain cells and their connections which can potentially improve memory and learning.